title: Characterization of health care provider attitudes toward parental involvement in neonatal resuscitation-related decision making in Mongolia.
abstract: The aim of this study was to characterize attitudes and practices among health care providers (HCPs) in Mongolia regarding parental involvement in neonatal resuscitation (NR)-related decisions. A voluntary, anonymous questionnaire was administered to 210 HCPs across 19 of 21 Mongolia provinces. Eligible HCPs included midwives, neonatologists, pediatricians, and obstetricians involved in neonatal-perinatal care in both rural and urban hospitals. A total of 210 pediatric HCPs were surveyed and 100 % completed all questions (response rate 100 %). Despite the absence of nation-wide guidelines, NR is uniformly performed at 32-weeks gestation across HCP professions and across rural/urban settings. Most HCPs (67 %) indicate that parents should be counseled about resuscitation, but only 9 % ask the parents if they want their extremely premature child resuscitated and only 17 % counsel the parents prior to birth of an at-risk infant. Most HCPs (72 %) prefer to unilaterally decide when to withdraw NR, and only 28 % indicated that both parents should be involved in the decision. Following a newborn's death, 75 % of all HCPs reported that they do explain the death to parents, although only 28 % reported receiving any training in parental grief counseling. For HCPs in Mongolia, a discrepancy exists between the perceived value of parental involvement and the actual practice of NR-related counseling. This report is a necessary first step toward understanding the factors that influence NR-related practices in Mongolia, and may serve as model for collecting these types of data in other low and middle income countries.
authors.affiliation: Division of Neonatology, Department of Pediatrics, University of Washington, Box 356320, Seattle, WA, 98195-6320, USA, mcadams@uw.edu.
authors.forename: Ryan M
authors.initials: RM
authors.lastname: McAdams
authors.forename: Ronald J
authors.initials: RJ
authors.lastname: McPherson
authors.forename: Maneesh
authors.initials: M
authors.lastname: Batra
authors.forename: Zagd
authors.initials: Z
authors.lastname: Gerelmaa
mesh_terms: D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D003422:Critical Care / Q000592:standards / Q000639:trends; D003657:Decision Making; D003906:Developing Countries; D005260:Female; D019538:Health Care Surveys; D006282:Health Personnel; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D008986:Mongolia; D010287:Parent-Child Relations; D033282:Parental Consent; D011247:Pregnancy; D018566:Pregnancy, High-Risk; D012151:Resuscitation / Q000592:standards* / Q000639:trends; D012424:Rural Population; D011795:Surveys and Questionnaires; D014505:Urban Population